Earth-Friendly Can Mean Budget-Friendly, Too

John Commins, for HealthLeaders Media, February 18, 2009

Rob Lester, director of food and nutrition services at HCA's two-hospital Ocala (FL) Health system, was looking over his cafeteria spreadsheets in early 2008 when he had an epiphany. "I saw where in 2007 we had used 400 cases of disposable plastic spoons that come in cases of 1,000. When you think about those in real pieces going to a landfill, it's disgusting," Lester says. "I stared at those notes for a couple of days. I felt like there had to be a way we could make an impact."

So Lester looked into switching the utensils and to-go containers in the cafeterias at 200-bed Ocala Regional Medical Center and nearby 70-bed West Marion Community Hospital away from plastic and Styrofoam and toward recyclable and biodegradable alternatives. To gauge staff support for the idea, Lester sent out a notice to the hospital's 1,500 employees about a special Earth Day event on April 22, 2008, telling them about the plans to go green. He asked vendors to provide a one-day supply of biodegradable and recycled food service containers and utensils. Staff tasted food served in containers made of bamboo, a biodegradable material that resembles Styrofoam, and shredded paper, using utensils made from a biodegradable polymer and sipping drinks from cups made of corn starch.

The overwhelming response he got from employees surprised him. "People were crazy about it," he says. "I felt like we had to do something with this. I met with the administration and asked if I could try to put together a green program. They said fine as long as I kept the costs in line."

That's when he looked at the high cost of biodegradable food containers and had a second epiphany. It turns out being earth-friendly isn't always budget-friendly. The lidded white Styrofoam to-go boxes that sell for 7 cents apiece were a bargain compared with the biodegradable to-go boxes that cost between 15 cents and 20 cents each. A 12-ounce Styrofoam cup costs 3 cents, while a biodegradable corn starch cup costs 20 cents. "When you think about how many thousands of those we hand out each month, it really adds up," Lester says.

With earth-friendly products costing about three times as much as the standard disposable containers and utensils, Lester knew the switch to green wasn't doable. That's when he had a third epiphany. "We use real plates and bowls and silverware on our patient tray line. I got to thinking, what if we go back in time and see if we can bring china plates and stainless utensils back to the cafeteria." Lester says. "They aren't that expensive and you can use them over and over again. We put it all together and crunched the numbers and figured out that if we could get staff and cafeteria customers motivated to use the real china and stainless when dining in, we might be able to pull this thing off."

When some staff asked if the plates and silverware were sanitary, Lester invited them to inspect the hospital's dishwasher. "I've got a serious dishwasher," he says. "Our machine hits it with steam and kills everything. That helped."

Lester couldn't find a reasonably priced biodegradable cup. So, he bought 500 reusable 20-ounce insulated travel mugs, each carrying the Ocala Health logo. He sold them to employees at cost, along with a 25% discount on drinks. The travel mugs quickly sold out. He ordered 500 more. They sold out. He's awaiting a third shipment. "The mugs were made with recycled materials. I didn't plan that, but it helped to sell them a little bit more," he says.

So far the program has been cost neutral, but the reduction in nonrecyclable waste has been impressive. In January 2008, before the green initiative, Ocala Regional used 243 cases of disposable products representing 206,530 pieces at a cost of $6,338. In January 2009, Ocala Regional used 127,000 pieces at a cost of approximately $6,500. About 55% of those 127,000 pieces were recyclable or biodegradable.

To-go containers remain a big expense. In January 2008 Ocala Regional used 7,600 Styrofoam to-go containers at a cost of $636. In January 2009 the hospital used 8,400 biodegradable to-go containers at a cost of $1,943. "The cost is just crazy," Lester says. "That just shows how expensive that biodegradable stuff is. But we did reduce the non-recyclables by almost 100,000 pieces so we feel pretty good about that."

Ocala's emphasis on earth-friendly practices has not gone unnoticed. Last month, the Ocala Chamber of Commerce awarded Ocala Health its Environmentalist of the Year award. Lester says the only reason the program works is because the staff is committed to the idea. "You have to sell it to your staff. If they aren't committed it's not going to work," he says.